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Published Date: 2005-10-14 23:50:00
Subject: PRO/EDR> Cholera, diarrhea & dysentery update 2005 (40)
Archive Number: 20051014.2997

CHOLERA, DIARRHEA & DYSENTERY UPDATE 2005 (40)
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The Journal of Hospital Infection
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In this update:
Asia
[1] Cholera - China (Zhejiang)
[2] Cholera - China (Shanghai)
[3] Cholera - China
Africa
[4] Cholera - Nigeria (Zamfara)
[5] Cholera - Guinea-Bissau
[6] Cholera - Guinea-Bissau, Senegal
[7] Cholera - The Gambia
Europe
[8] Dysentery - Ukraine (Khmelnitsky)
[9] Cholera - Worldwide - WHO WER Notifications
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[1] Cholera - China (Zhejiang)
Date: Sun, 9 Oct 2005
From: ProMED-mail <promed@promedmail.org>
Source: XinHuaNet.com [edited]
<http://news.xinhuanet.com/english/2005-10/09/content_3599095.htm>

A total of 158 cases of cholera had been confirmed as of 8
Oct 2005 in Jiaxing, a city in east China's Zhejiang
Province, since 25 Aug 2005 when the 1st case was found,
local health authorities said Sun, 9 Oct 2005, adding that
no deaths had been reported.
Most of the patients were only slightly affected by the
waterborne disease, with the syndrome of painless diarrhea
and vomiting but no fever, sources with the Zhejiang
Provincial Department of Health said. The sources said 72
patients remained hospitalized.
Autumn is a popular season for such acute intestinal
epidemics as cholera, typhoid fever and diarrhea. In
addition, Jiaxing is an area which is interconnected with
waters and has also been a popular area for intestinal
epidemics. Local health authorities attributed the outbreak
of cholera this year mainly to unclean drinking water and
unclean diets. They suggested people pay more attention to
personal hygiene to prevent the disease.
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[2] Cholera - China (Shanghai)
Date: Fri, 14 Oct 2005
From: ProMED-mail <promed@promedmail.org>
Source: Shanghai Daily [edited]
<http://www.shanghaidaily.com/art/2005/10/14/202245/7_reports_of_cholera_prompt_calls_for_hygiene.htm>

7 cholera cases were reported between July and September
2005 in the Shanghai Municipality, but no deaths were
reported in the 3rd quarter, the local health bureau said in
a quarterly report.
Meanwhile, over the past 5 months, fewer cases of intestinal
infectious diseases such as bacterial and amoebic dysentery,
typhoid, cholera and diarrhea have been reported in the city
as compared to same period in 2004.
******
[3] Cholera - China
Date: Tue, 11 Oct 2005
From: ProMED-mail <promed@promedmail.org>
Source: XinHuaNet.com [edited]
<http://news.xinhuanet.com/english/2005-10/11/content_3606331.htm>

China's health ministry warned localities here Tue, 11 Oct
2005, to improve their alert level for the epidemic disease
of cholera, citing a rocketing growth compared with the same
period in 2005 [sic? 2004].
It said in a quarterly surveillance report that China
reported 638 cholera cases from June to September 2005, most
in the country's eastern Fujian and Zhejiang provinces, 275
per cent higher than the 170 cases year-on-year [in 2004?].
All localities should further enhance their prevention and
control measures, said the ministry. "The regions reporting
relatively more cases should especially strengthen
monitoring efforts and introduce positive and effective
measures to bring the epidemic under control as early as
possible."
******
[4] Cholera - Nigeria (Zamfara)
Date: Mon, 10 Oct 2005
From: ProMED-mail <promed@promedmail.org>
Source: The Tide News [edited]
<http://www.thetidenews.com/article.aspx?qrDate=10/10/2005&qrTitle=LG%20dispatches%20medical%20team%20to%20contain%20cholera%20outbreak&qrColumn=NEWS>

The Maradun local government of Zamfara State has dispatched
health officials to Faru village following a reported
outbreak of cholera in the area. The council chairman,
Alhaji Abubakar Aliyu, told newsmen in Gusau on Fri, 9 Oct
2005, that the team was expected to ascertain the true
picture of the situation, including casualty figures.
Aliyu, who was reacting to rumors that the disease had so
far claimed 50 lives, said the team would ascertain the
veracity of such claim, and check the spread of the disease.
"Whenever an outbreak of any disease is reported to us, we
normally send our health personnel to find the true position
of things, and this is what we did," he said.
Aliyu said that the team, led by the council's NPI manager,
was also directed to determine the cause of the outbreak
with a view to taking necessary steps to prevent future
occurrence.
"Up to the time I am speaking to you now, I have not
received a report of any death," he said.
Efforts to contact the state Commissioner for Health, Alhaji
Bello Buzu, failed, as he was said to be on official
engagement.
******
[5] Cholera - Guinea-Bissau
Date: Sat, 9 Oct 2005
From: ProMED-mail <promed@promedmail.org>
Source Angola Press[edited]
<http://www.angolapress-angop.ao/noticia-e.asp?ID=381642>

The number of cholera cases in Guinea-Bissau has risen
recently after declining considerably at the end of Sep
2005, the government said in a statement issued after a
cabinet session here Fri morning, 7 Oct 2005.
According to the director general of public health, Tom Ca,
a total of 233 news cases were recorded in the country on
4-5 Oct 2005.
To prevent the aggravation of the situation, the government
has re-imposed its ban on the vending of water, home-made
fruit juice and ice in the street and other inappropriate
places. The cabinet has also suspended gatherings at all
traditional ceremonies and parties. These measures were
lifted following a reduction in cholera cases.
According to hospital sources, cholera has killed 295 out of
the 18 000 cases reported since 11 Jun 2005.
62 patients died in Bissau out of the 9904 cases reported in
the country's capital, while 33 died out of the 3247 cases
diagnosed in Biombo, north western Guinea-Bissau.
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[6] Cholera - Guinea-Bissau, Senegal
Date: Wed, 12 Oct 2005
From: ProMED-mail <promed@promedmail.org>
Source: IRIN [edited]
<http://www.alertnet.org/thenews/newsdesk/IRIN/dcfd4d55751b5f439d00121c4b7f3469.htm>

Deaths in the cholera epidemic raging in tiny Guinea-Bissau
have passed the 300 mark, prompting authorities to ban the
sale of drinks and food by street vendors as well as forbid
all traditional ceremonies.
The health ministry said on Wednesday that the epidemic has
claimed 305 lives and stricken 19 054 people in 4 months.
Sources in the ministry said that despite measures to halt
the spread, the 4 month old epidemic was gaining ground.
Cholera is a waterborne disease that surfaces in parts of
West Africa at each rainy season when wells and sewage spill
over. The intestinal infection, caused by contaminated food
or water, can kill within 24 hours by inducing severe
vomiting and diarrhea.
The Guinea-Bissau government late last week imposed a ban on
all traditional rites and ceremonies for at least 30 days,
as large gatherings are a major conduit for the highly
contagious disease.
More than half the cases have occurred in the capital,
Bissau, a city of 300 000 built on low-lying land on the
banks of a muddy estuary.
Endemic in some countries in the region, cholera hit the
capital of neighboring Senegal in late 2004 for the 1st time
in 8 years and has remained entrenched. With unusually heavy
rains in Dakar in 2005, the Senegalese health ministry by 2
Oct 2005 had reported 25 573 cases, including 352 deaths in
2005.
And with 60 000 people made homeless by flooding in Aug and
Sep 2005 and the rain continuing, Senegal in just the first
3 days of this week registered 433 cases a day and 12
deaths, the ministry reported.
The mortality rate is higher still in impoverished
Guinea-Bissau, where poor infrastructure -- stemming from
the 1998-1999 civil war and subsequent instability --makes
treatment difficult.
"The epidemic has not abated yet," said Claire-Lise
Chaignat, the leading cholera expert at the UN World Health
Organization. "With the rains continuing it could get
worse." Chaignat said improved public health and hygiene
measures were vital to combat the disease across the region
where several countries have been hit. "We must prepare for
next year," she told IRIN by telephone from Geneva. "We need
to train health workers and inform the public about the
basic hygiene needed to combat cholera."
With Muslims currently observing the holy month of Ramadan,
extra care must be taken around communal meals, she said.
"We must be vigilant during the month of Ramadan or there
could be a resurgence."
******
[7] Cholera - The Gambia
Date: Mon, 10 Oct 2005
From: ProMED-mail <promed@promedmail.org>
Source: AllAfrica.com and The Independent (Banjul)
<http://allafrica.com/stories/200510110941.html>

The department of state for Health has confirmed over 20
cases of cholera cases in the country.
The disease control coordinator at the department of state
for Health and Social Welfare Sana Sambou told The
Independent that at least 20 people are confirmed to be
cholera-infected from the medical and laboratory unit. Mr
Sambou stated that they admitted suspected patients in Sep
2005. "It happens to be linked to somebody who traveled
outside The Gambia and returned with the disease," he said,
adding that despite this case, many suspected of contracting
the disease were admitted and discharge. "So far, no one is
reported death due to the disease and that Western Division
is the only area affected."
When quizzed as to how his department plans to tackle the
outbreak, Mr Sambou stated that the Health department is
vigilant and making sure that all the public health
facilities are fully equipped with essential drugs and other
necessary supplies.
He said they are strengthening health facilities in terms of
human and material resources, sensitization of health
workers and the public, resource mobilization and allocation
and cross border surveillance in order to control the
situation. "Despite these, people should be involved in
their own welfare. They should report any sign of cholera to
the nearest health facility. They should also make sure that
foodstuffs that are for sale are covered and are of good
quality and standard for human consumption. People should
also observe personal hygiene and environmental sanitation,"
he advised.
[byline: Muhammed J Sankano]
--
ProMED-mail
<promed@promedmail.org>
[In this posting, it appears to be the case that the initial
case or cases were imported with subsequent local spread. -
Mod.LL]
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[8] Dysentery - Ukraine (Khmelnitsky)
Date: Sun, 10 Oct 2005
From: ProMED-mail <promed@promedmail.org>
Source: UNIAN.net /AP [edited]
<http://www.unian.net/eng/news/print-87614.html>

More than 330 school children in western Ukraine were
hospitalized with food poisoning, including 4 who were in
critical condition, an emergency official said on Sat 8 Oct
2005, according to AP.
The first 299 children, aged between 2 and 6, became ill on
Fri, 7 Oct 2005, possibly from food prepared at 7
kindergartens in the Khmelnitsky region. An additional 33
were hospitalized later Saturday, he said.
Health Ministry official Tetiana Yurchenko said a
preliminary investigation showed that the source of
infection as a dysentery bacterium in kefir, a popular drink
made of fermented milk.
"It's up to the investigation to establish how the dysentery
bacterium got in the kefir," she said.
The Defense Ministry sent military medics and was setting up
60 beds in 2 military hospitals to help treat the children.
In 2004, poor hygiene at state-run dairies caused an
outbreak of food poisoning among more than 800 children in
the country's three regions, including the capital, Kiev.
******
[9] Cholera - Worldwide - WHO WER Notifications
Date: Fri, 14 Oct 2005
From: Marianne Hopp <mjhopp12@yahoo.com>
Source: WHO Epidemiological Record, 14 Oct 2005
<http://www.who.int/wer/2005/wer8041/en>

Notifications of cholera received from 7 to 13 Oct 2005
------------------------------------------------------
country / dates / cases / deaths
Africa
Benin 5 - 25 Sep 2005 / 150 / 4
Cameroon 1 Jul - 25 Sep 2005 / 701 / 60
Guinea 1 - 25 Sep 2005 / 597 / 13
Guinea-Bissau 25 Sep - 4 Oct 2005 /1628 / 17
Mozambique 5 - 18 Sep 2005 / 97 / 0
Senegal 26 Sep - 2 Oct 2005 / 1036 / 25
Europe
Belgium 17 Sep 2005 / 2(i) / 0
Poland 31 Aug 2005 / 1(i) / 0
[ProMED-mail would appreciate information regarding the
imported cases reported from Belgium and Poland as shown
above. - Mod.LL]
--
ProMED-mail
<promed@promedmail.org>
[Elsevier reference: Walker RI. Considerations for
development of whole cell bacterial vaccines to prevent
diarrheal diseases in children in developing countries.
Vaccine 2005; 23: 3369-85
<http://www.sciencedirect.com/science?_ob=GatewayURL&_origin=SDPROMED&_urlVersion=4&_returnURL=&_method=citationSearch&_version=1&_volkey=0264410X%2323%233369%2326&md5=288cc74d5f8b86009c021d2cdebcbe48>]

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